The use of CT has rapidly increased since its introduction. Although an important medical tool for diagnosis and treatment, CT is recognised as being among the highest contributors to population radiation exposure. As the risks associated with exposure are higher for children than for adults, this study assessed the impact of paediatric CT in Australia by analysing imaging trends. CT imaging trends were derived from Medicare data. Comparable data from a dedicated paediatric hospital (Royal Children's Hospital Melbourne (RCH)) were analysed to determine the validity of utilising Medicare statistics in the younger age groups. The resulting trends reflect the situation for paediatric CT imaging in Australia. In 2009, 2.1 million CT services were billed to Medicare in Australia for children and adults. The average annual growth in the number of CT services provided since 1994 was 8.5%, compared with population growth of 1.4%. Comparison of RCH and Medicare data revealed that only one third of paediatric CT imaging is captured by Medicare. Combining the data sets showed that over the last 20 years, there has been an average annual increase of 5.1% in the CT imaging rate for 0 to 18-year-olds. However, in recent years, growth in the imaging rate for 11 to 18-year-olds has slowed, while for 5 to 10-year-olds the imaging rate has declined. The significant growth in CT services is attributable to increased demand from the adult demographic. Conversely, increases in the imaging rate for paediatric patients have slowed overall. In fact, for some age groups the rate has fallen. © 2011 Australian Government (ARPANSA). Journal of Medical Imaging and Radiation Oncology © 2011 The Royal Australian and New Zealand College of Radiologists.